Why are there no alternative ICUs?

Medical Team Working On Patient In Emergency Room

I’ve got a great idea for a new medical drama: Homeopathy 911!

It takes place in a quackademic medical center and follows the lives and loves of alternative medical practitioners.

Can’t you just imagine the scenes in the ER?

“Nurse, get me the reiki practitioner STAT!!”

Or how about the crises in the ICU where young practitioners struggle to mix homeopathic preparations in massive amounts of water to create super-dilute medications for super sick people? It’s the perfect backdrop for illicit sex.

And what about tension in the operating room as chiropractors struggle to manipulate the beautiful innocent bystander hemorrhaging to death after being struck by gang warfare bullets? Is it any wonder that the married nurse falls for the hunky chiropractor once she sees what he can do with his hands?

And then it occurred to me:

There are no alternative Emergency Rooms.

There are no Quacktensive Care Units (QCUs).

And the only surgery performed by purveyors of pseudoscience is the wallet biopsy. If it comes up green, they proceed with treatment.

There are none of these things because alternative practitioners don’t take care of sick people; they don’t even know how to take care of sick people. They only care for the worried well, carefully separating them from their money by shilling herbs, supplements, books and DVDs that no one needs because they are utterly, spectacularly ineffective!

Alternative medicine isn’t medicine; it’s trickery. It’s the placebo effect writ large.

Even practitioners of alternative medicine recognize that it doesn’t actually work. That’s why there are no alternative hospitals, no alternative free clinics, and no medical missions to treat Ebola with homeopathy, or reiki or chiropractic. Its own practitioners recognize that alternative medicine only “works” in first world societies where well off people have discretionary income, not in underdeveloped countries where poor people can’t pay. And it only “works” to enrich alternative providers, not to diagnose, prevent or treat actual diseases.

So I guess Homeopathy 911! is a non-starter.

Hold on! I have another idea.

How about a reality show about women, influenced by midwives, doulas and childbirth educators to view birth as a piece of performance art, choosing to giving birth unattended in the wild.

Wait, what? Lifetime has already thought of that and Born In The Wild, will debut soon?

Hmmm. Maybe Homeopathy 911! isn’t such a bad idea after all.

  • Courtney84

    So I saw an acupuncturist while dealing with IF. I enjoyed it and found it relaxing. I believe it’s possible acupuncture does things we can’t define or quantify. I also believe it’s possible that it’s just relaxing for some people and a good dose a placebo. I can afford to have a few acupuncture sessions when I want to get pregnant. I don’t think I’m crazy for seeking their care. I do admit, it’s difficult to find a practitioner that I think is credible.

    What I don’t understand is this movement to spend lots of money on homeopathy, reiki, chiropractic, etc while claiming it has all sorts of unproven benefits. I think the same people who support these alternatives, denounce doctors especially oncologists. Why is it oncologists are just shills for big pharma but there’s no concern about the money making aspect of alternative health care providers?

  • Rachele Willoughby

    That’s why there’s such an abundance of woo in the NCB movement. Because most of the time if you leave a pregnant woman alone to labor they get lucky and don’t die. This gives the midwife the opportunity to brag about how she delivered the baby naturally/ saved the mother/baby through her brilliance and adherence to NCB philosophy. As opposed to, you know, patients with appendicitis.

  • CrankyTorontonian

    A British comedy duo, Mitchell & Webb, made a skit about a homeopathic ER some years back! The best part is right at the end….http://youtu.be/HMGIbOGu8q0

    • Nick Sanders

      That’s the third time that video has been posted to this entry. :p

  • Anonymous

    You can almost smell the lawsuit coming off that show.

  • Margo

    Margo woo zealand…..www.rcm.org.uk discusses labour support and pain, many other websites dx similar. I am not saying right or wrong , what I am saying is apparent lack of respect for women choosing alternative methods! lack of respect re health professionals who may hold views that differ from one’s own. you don’t have to agree with any of it, but mocking is not that helpful and does not advance knowledge.

    • Young CC Prof

      Mental techniques to cope with pain are real and useful things, although they have limitations.

      I just wish the classes that teach them to pregnant women didn’t serve it up with a side dish of anti-science, like “epidurals will drug your baby” and “induction is part of a cascade of interventions that causes c-sections,” neither of which is true.

      • KeeperOfTheBooks

        Right. I wouldn’t mind a class on mental techniques to cope with pain for my next pregnancy. Leaving aside anything else, we’re about an hour from the hospital at which I deliver, and I imagine that whatever my epidural plans, that car ride will not rank on my “Top Ten Things I Wanna Do Again.” That doesn’t mean it’ll replace an epidural when I do get to the hospital.

    • CrownedMedwife

      Holding different views does not equate to advancing knowledge either. You can hold all the views you’d like. However, if you are providing care or pushing an agenda inconsistent with care established to be a safe practice, then your views are not unique or alternative, they are dangerous.

      Suffice it to say, despite your comment downthread, Dr. Amy does not disparage us all. The members of this profession, midwifery, with it’s breadth of licensure requirements and tendency to permit beliefs over knowledge disparage us all. We do it to ourselves. Our profession does it by ACNM pairing with MANA, by not demanding a level of care and review consistent with every other health care provider, by misplacing experience over outcome. It took time and reflection for me to realize that by embracing the term Medwife and distancing myself from being a Midwife was not abandoning my profession, rather moving forward with a new personal standard for my profession. (As a wise commenter here once told me, “Medwife-you say it as if it’s a bad thing?”). So if you’re practicing outside established guidelines, valuing experience over outcome, isolating yourself from the community of Obstetrics or imposing personal values on the care and course of women’s pregnancy and birth, then yes, you will be disparaged. Rightly so. If not, then there is little on this blog, lest from Dr. Amy, to cause a sense of defensiveness or disparagement.

    • PrimaryCareDoc

      I have nothing but lack of respect and mocking for health “professionals” that use woo and prey on patients in order to line their pockets.

      Health care is science based. Not “belief” based or “view” based. Science.

  • Margo

    Margo woo zealand…How about a show where people are respected for their beliefs.How about a show where professions are not insulted out of hand. how about a show where midwives, god damn it, are not the butt of endless disparaging remarks, how about a show that honours truth and compassion. How about that!!! Sometimes your page dishonours us all , professions and pregnant women alike with its rudeness and throw away comments., ie performance art. I am angry with this page today.

    • Who?

      Margo, I get you are angry. Dr T has never claimed to have a positive tone, and her site gets a lot of traffic-if you want something with the same message but more diplomatically put, have a look at the links on the right hand side.

      But whatever do ‘beliefs’ have to do with best practice health care?

      If midwives did practice best practice healthcare, based not on their beliefs but on medical knowledge, Dr T would have a whole lot less to write about. If doulas stuck to doling out ice chips and crooning kind words, same thing.

      • Margo

        Margo woo zealand. Possibly so, however, not all medical intervention around childbirth is positive, I worked in a unit that embraced The Dublin Experiment, where all primips if on ve were 3cm dilated, had their waters broken and Syntocinon via IV put up to hasten the labour/birth process…..further down the years this intervention was thrown out, how the policy was changed was by data collection…stats….not ridicule. It was a belief, it was challenged, it was discontinued.

        • Who?

          I’d call that a trial, not a belief. If it was about belief, it would probably still be going on.

          Not all medical treatment is always positive. That’s why records are kept, notes are compared and outcomes reviewed. Doing the follow up helps everyone learn what actually works, as opposed to what feels good or seems like ‘common sense’.

          The road to hell is paved with good intentions. Meaning well and doing your best is not the same as achieving optimal outcomes.

          I think you’ll find it is the alternative side of the equation who are worse at record keeping, worse at acknowledging their responsibility for things that don’t go well, and very good at covering up.

        • Dr Kitty

          I trained in the hospital that wrote the Dublin Protocol.
          AROM at 3cm was standard, but syntocinon was only used if people fell off the partogram, it wasn’t universal and all women had the option to opt out.

          They had a CS rate of under 20% despite being a tertiary referral hospital with a level 3 NICU and an obstetric ICU, and a successful VBAC rate of over 70% with enviable maternal and perinatal morbidity and mortality rates and very high maternal satisfaction.

          It worked for them and their population of young, white, Irish women who had large, closely spaced families.
          You didn’t replicate their outcome in your unit, doesn’t mean that the protocol wasn’t useful in Dublin.

          • Medwife

            Question- did they use syntocinon on vbacs who fell off the curve?

            The satisfaction rates in the Dublin protocol are consistent with every study I’ve read on expectant vs active management. Women don’t want to be in labor for days. Get it over with. My labor was kind enough to stick to the Friedman curve. Days of active labor is just torturous.

            Edited for typo and Americanism

    • birthbuddy

      You earn respect or you earn ridicule.

    • Nick Sanders

      Beliefs stop being respectable when they lead to avoidable harm.

    • Bombshellrisa

      You know what really dishonors midwives and pregnant women? midwives who insist support takes pain away. Midwives who insist Pacific women don’t feel pain and get on with the business of labor and birth because of this. Midwives who completely disregard the pain of labor and yet whine about how much THEY hurt when they got an IV. I have no problem respecting professional midwives who take the health and concerns of their patients seriously, which would not include suggesting reiki, homeopathy or chiropractic and certainly would not include the belief that support takes any kind of pain away.

    • staceyjw

      Maybe they ought to stop embarrassing themselves? They are too easy to mock, all you need to do is post their own words!
      And MWs are NOT disparaged here. CNMs are respected, unless they have gone off the woo side, but OBs are ALSO disparaged for this! Of course lay MW/CPM are talked about badly, they are laymen that care at best, and murderous sociopaths with many deaths being hiddenat worst.

  • lion

    There is quack medicine in developing countries. It is called traditional medicine. Where I am from it involves throwing bones, buttons and random bits and bobs for diagnosis and then wearing amulets, and taking medicines known as mutilate made from all sorts of ingredients including battery acid.

    • lion

      It is still used by many in rural areas even though there is access to proper medical care.

      • Sue

        As access to effective medicine becomes greater and easier, it tends to be adopted, no?

        • Nick Sanders

          There are always holdouts. Even in the industrialized USA, there are still plenty of people who rely on faith healing.

  • Mel

    Who needs Born in the Wild when you have the Duggars?

    When I was exercising at a gym, I watched 30 minutes of a “19 Kids and Counting” episode. (30 minutes of my life I’m never getting back, although I got more mileage than usual because I was channeling the rage into my legs) Jill delivered a baby – and with no sense of irony said “We can do the same things an OB can plus we get to know you and become friends!”

    Wait….someone who has a high school diploma with science classes that are sadly below standards for public schools can do EVERYTHING an OB can? Really? Jill could perform the CS that saved several of her siblings lives and her mother several time? Really?

    That’s when it hit me: She is so uneducated that she doesn’t know what she’s ignorant of….and I’m guessing that’s not an uncommon occurrence in natural medicine and NCB.

    • The Bofa on the Sofa

      That’s the Dugger-Kruger syndrome – oh, wait…

      • Young CC Prof

        Oh, snap.

    • Stacy48918

      The Duggar kids are graduates of The School of the Dining Room Table. Do they have high school diplomas or GEDs? There is “testing” required by Arkansas for home school students, but I imagine this covers more reading/writing/math than science, but I don’t know for sure. I imagine there are many things that the Duggar kids don’t know, but think they do.

    • Munkie

      There was an episode where she attended a delivery where a portion of the umbilical cord was enlarged from the intestines protruding into it. None of them knew what to do so they called the EMTs and the baby was taken to the hospital. You know for real medical care.

      • Medwife

        I’m glad for that. Maybe if the cameras hadn’t been there it would have been done a little differently.

    • Bombshellrisa

      “We can do everything an OB can do”–NOT. All the OBs I know are also GYNs and surgeons. There is a reason it takes lots of education and training to be an OB/GYN. Then again, it tells you how much these chicks know about what doctors do. Scary.

  • Cobalt

    I know Born In The Wild isn’t going to have actual wild conditions (camera crew, medical chopper, access to grocery stores and central heating throughout pregnancy), but I find the entire premise to be more offensive because of that. Making an entertainment of an event, starring those privileged with choice and access, that regularly injures and kills those who are forced to participate, like women in areas without access to modern obstetrics, is wrong.

    If there is an interest in birth in very low resource environments, why not go to those places, interview those women who live that experience.

    • Nick Sanders

      I’m sad that I can only give this one upvote.

    • Bombshellrisa

      Yes! PRONTO International and The Helping Babies Breathe project gives presentations about birth and treating complications in low resource environments. Plenty of these presentations are available online. Of courses, while the doctors and midwives who present are warm and obviously love helping people, there is decidedly no glitter and unicorns vibe and no mention of cinnamon candy.

  • Laura

    I had a facebook friend post an article from “Natural News” that fully vaccinated kids are getting measles. How likely is this to occur?

    • Young CC Prof

      The vaccine is at least 99% effective after 2 doses. Unfortunately, this means it is up to 1% ineffective, and that a small number of fully vaccinated people can catch the disease, especially if they are heavily exposed by prolonged close contact with an infected person.

      Note that a majority of cases are occurring in unvaccinated children and young adults, even though most of the population is vaccinated.

      So, can it happen? Yes. Will it happen to your family? Highly unlikely.

      • Cobalt

        Math question:

        If measles infects 90% of unvaccinated exposed persons, and 1% of vaccinated exposed persons, and the vaccination rate is 95%, and 100 people have measles, then how many people were exposed and didn’t get measles, and of those, how many were vaxed vs. unvaxed?

        • Young CC Prof

          Not enough information. You need to know how large the population is, and who came in contact with who when.

          Assume that the outbreak is over and you’re counting chips, everyone in the population was exposed, and we know that 95% of those were fully vaccinated. We will skip the added complication of degrees of exposure, and assume all vaccinated people had both doses. We will also assume that the 90% and 1% numbers held perfectly, rather than screwing around with confidence intervals.

          This are some pretty strange assumptions, but maybe this outbreak happened at a really big one-room schoolhouse or something.

          So, we set up an equation to find the population size:

          (.95)(.01)x + (.05)(.90)x = 100

          Then the population of exposed people is 1835.

          We further find that there were 1743 vaccinated people, of whom 17 got sick, and 92 unvaccinated people, of whom 83 got sick.

          Once again, I emphasize this is not a good way to do math, since it doesn’t work like this in the real world. A large population isn’t going to be 100% exposed all at once. But, it makes a nice thought experiment.

          • Cobalt

            Just looking for a simple frame for a thought experiment, no medical or public health recommendations are relying on the numbers :). I have a friend that was asking me about the vaccinated people who got sick, and I need a simple set of numbers to show what’s possible. Accounting for too many variables makes it too complicated for most people without a statistics education.

          • Cobalt

            Would it be reasonable to say that in a situation like Disneyland, where there are a bunch of people all in the same place (not quite a one room schoolhouse, but as close of a real world situation to that is as likely to occur) that those numbers would be SOMEWHAT accurate, or are there still too many unaccounted-for variables to make that a useful diagram?

            I don’t need to be 100% precise, but I don’t want to make a bad example either.

          • Young CC Prof

            It works as a thought experiment or biological model. It’s also worth seeing whether the ratio of fully vaccinated to totally unvaccinated patients is following what the vaccination rate predicts.

        • fiftyfifty1

          here’s my guess (assuming uniform distribution of non-vaxers in the community and uniform exposure):

          To get 100 cases of measles, you have to expose 1835 people. 100 will get it, 1735 won’t.

          Of the 100 who get it, 83 will be unvaxed and 17 will be vaxed.

          Of the 1735 who don’t get it, 9 will be unvaxed and 1726 will be vaxed.

        • Mariana Baca

          Here is the solution, this is a simple two variable/two equation algebra problem.

          y = number of unvaccinated people

          x = number of vaccinated people

          1) .01x + .9y = 100

          2) x/y = .95/.05

          simplify:

          1) x +90*y =10,000
          2) x/y = 19
          3) x = 19*y
          insert x into y:
          1)19y + 90 y = 109y = 10,000

          thus:
          y = 92
          x = 1743

          83 of the 92 unvaccinated people get measles. 17 of the 1743 vaccinated get measles. 100 people get measles total out of 1835 people.

      • Roadstergal

        This is one question I was wondering about the ‘vaccinated’ cases who got measles – do they report separately those who had only gotten one dose of the vaccine, or are they counted as ‘vaccinated’?

        • Young CC Prof

          Most reports counted them separately, definitely the CDC does. And they counted preschoolers who’d had only one dose separately from older folks who’d never had a booster.

          • Roadstergal

            I’m just wondering about the numbers used when the anti-vaccination brigade crowing that ‘x vaccinated kids got the measles!’ and saying it’s proof that the vaccine doesn’t work. We already know that’s not the case from the math below, but in addition, I’m wondering if their numbers are ‘contaminated’ by using kids who haven’t gotten the full set of vaccines (kids who, normally, would be protected by herd immunity until they got all the doses).

          • Young CC Prof

            Number one, yes, they do blur fully vaccinated versus partially vaccinated.

            Number two, many antivaxxers can’t read, and they often have the numbers flat-out wrong in the comments section of a news article about a measles outbreak that explicitly listed vaccinated versus unvaccinated measles.

            Number three, yes, they really do want 100% effectiveness.

          • Roadstergal

            “Number three, yes, they really do want 100% effectiveness.”

            I never know what to do with that attitude. Other than encourage them not to wear seatbelts or use child seats, since they don’t work a full 100% of the time to prevent injury and death.

            I wonder if it would be possible to break their brains by telling them not to breastfeed, since I’m sure some EBF children got measles in the recent outbreak.

          • Nick Sanders

            Funny you should say that. In the comments section of an article elsewhere, I came across an antivaxxer hollering about how you couldn’t pay her to wear a seatbelt.

    • Roadstergal

      If you go here and type Natural News into the search box, you’ll learn all you need to know about that rather interesting site and its interesting relationship to the truth.
      http://scienceblogs.com/insolence/

      • Laura

        I had serious doubts as to the credibility of this source from the name alone!

  • Kesiana

    And the only surgery performed by purveyors of pseudoscience is the wallet biopsy.

    Actually, about that…

    (If the link preview doesn’t show up properly, it’s a short YouTube video debunking “psychic surgery.” Content warning for fake blood… and okay, technically this isn’t really supposed to be science, but it’s interesting!)

  • Sue

    IN a vaguely similar veing, check out this YouTube series that parodies cooking shows. This one on going sugar-free is simply brillliant:
    https://www.youtube.com/watch?v=8UZJRR8OHhY

    • Sue

      (”veing” is not a word. I meant ”vein”)

    • Who?

      Ah yes love it.

    • fiftyfifty1

      genius!

  • Lisa Murakami

    This one is pure gold. Love it.

  • slandy09

    You should have shared this video…

    https://www.youtube.com/watch?v=HMGIbOGu8q0

    • Nick Sanders

      Hey, no fair, I posted that first.

      • slandy09

        Whoops! Sorry! I didn’t see it when I was scrolling the first time.

    • Libby Cone

      Oh, I love that video! I’m glad you thought of it!

      • Nick Sanders

        But I thought of it before they did! *whine*

  • Daleth

    There actually are free acupuncture clinics, as well as an international organization called Acupuncturists Without Borders. There are also acupuncture clinics or practitioners in some US hospitals. Here’s an article about a free clinic within a hospital: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745291/

    Maybe acupuncture isn’t what you’re referring to, since there are peer-reviewed studies showing that acupuncture works for certain things. I just thought I’d mention it because a lot of people lump it in with quackery.

    Also, every reiki practitioner I’ve known has confessed to doing reiki for free, often without telling the person they were doing it to, whenever they thought it could help someone who was injured or sick. An RN I knew who also did and taught reiki always used to do it on her patients if she thought they needed extra help. At the very least they do believe that what they’re doing is helping. I haven’t heard any of them spout the kind of self-centered garbage you’ve quoted here from some nutty doulas and homebirth “midwives.”

    • Sue

      Actually, Daleth, the evidence for acupuncture is very thin. There is some RCT evidence for effectiveness in subjective pain, but none for actual pathological processes. It seems to be another elaborate placebo. I don’t really understand why medicine has (partially) embraced it, as it is not without risk (as opposed to meditation, for example).

      As far as Reiki goes, providing a placebo for free is better than charging for it, I guess. Touching therapies can be quite therapeutic – you don’t need a pseudoscientific explanation.

      I also provide a type of placebo during my acute medical practice, but it’s open and not deceptive. It’s called conversation and physical comfort – food and drink, warm blankets etc.

      I am salaried so I don’t exactly provide it for “free”, except that all ED visits are covered by Medicare for all Australians, so I guess it is.

      • Young CC Prof

        I spent a fair bit of money on acupuncture back in the day. Not a lot, but at the time I didn’t have a lot. After all, everyone knew it worked.

        I was furious when I got a real look at the literature and understood that there was really truly nothing there at all, other than a small risk of infection.

        • Sue

          Yep. I’ve read a few good reviews that show that sham acupuncture, not utilising the “meridians”, is just as good a placebo.

          The old tropes of ”been around for hundreds of years” and ”millions of CHinese use it” are always bandied about. Many myths have been around for thousands of years – including astrology and demonic possession. Meanwhile, the huge impoverished rural populations of China and INdia, who previously had no access to therapies beyond what was available at the village level, are embracing effective medicine when they can get it.

          • SporkParade

            I maybe have a little too much fun telling people, “Oh, no, I couldn’t do acupuncture/gender predicting calendars/herbs. My Chinese cousins would kill me for buying into primitive superstition.” You’d think Chinese and Indian people have lived in the US long enough to put a stake through the heart of the mystical Asian stereotype by now…

          • KarenJJ

            Reading “Mao’s Last Dancer” gave some interesting insight into how Chinese people who were forced to use traditional chinese medicine due to a lack of resources actually viewed traditional chinese medicine.

          • Roadstergal

            Even sham acupuncture where the needles don’t actually pierce the skin work as well. Which, from a risk/benefit analysis, means that acupuncture where you pierce the skin is now fully unethical, IMO.

        • KarenJJ

          Same and did it throughout IVF at one stage. I *hated* acupuncture. I was very happy to get further info that it was likely ineffective from my obgyn and IVF clinic nurse.

          • just me

            But there mare peer reviewed studies showing it can help with blood flow issues and implantation.
            http://yourivfacupuncture.com/what-is-the-process/research/
            Yes, it’s an acu web site but cites to studies are there.

          • KarenJJ

            My obgyn and the IVF nurse had also reviewed the current information when they told me that back in 2008 (come to think of it the wording they used was something like ‘showing to be less effective with the latest information’). So unless these studies are more rigorous and more recent than that I’d probably discount them personally. I’m a ‘always discuss with your doctor’ kind of person because if they know about the issue, they have probably already looked into it.

          • Young CC Prof

            Basically, the study found a benefit in one measure and/or one subgroup. Which always happens, because random chance.

          • Nick Sanders
          • just me

            Right. And my docs–best infertility clinic in the country–cCRM–not quacks–had looked into it and prescribe acu for blood flow issues and also transfers. So, yeah.

          • KarenJJ

            Maybe a recommendation has changed in the last few years or maybe a very small benefit was discarded by my clinic due to the increased costs vs benefit calculation (government subsidised IVF). I also went through one of the best/most well-known fertility clinics in the country. Different country 😉 It’s why I’m very keen on discussing with doctors that know you, work in your medical system and understand the latest research.

          • KarenJJ

            My clinic was also very much against anything more than SET. Different system, different priorities, different risk vs benefit.

          • Daleth

            Ditto. I went there too. You can’t get farther from quacks than CCRM, when it comes to fertility medicine. Their success rates speak for themselves, and are all the more impressive when you factor in that many patients go there only after multiple failures at other clinics.

          • fiftyfifty1

            The studies you link to are very low quality, preliminary studies. They are plagued by tiny sample sizes and lack of suitable controls. If these are what your fertility clinic is making recommendations off of, that is poor medicine. Infertility medicine is under huge pressure to “go with the flow” on the issue of alternative remedies. Many patients with infertility are pretty desperate, and docs get criticized if they are “too medicalized” and “don’t treat the whole person”. I think too many docs give up the fight on this one, and become only too glad to throw the patient a bone, and give them something “positive to keep them busy” until the real treatments are successful. It’s too bad.

          • Young CC Prof

            As with all alternative medicine, trying to satisfy existing demand in the least harmful way risks creating more demand.

          • fiftyfifty1

            I agree. I also can’t help but regard their motivations somewhat cynically. At best, the motivation might be to “keep those anxious patients out of my hair”. At worst, it might be a marketing ploy. Fertility clinics typically derive a big portion of their income from self-pay. A fertility clinic could easily hire a full time acupuncturist, pay them $60K/yr, provide this service at no cost to patients, and not even miss the money. But imagine what that would do for attracting clients! Why choose the cold, medicalized clinic across town where you feel like nothing more than a defective pelvis? Why not end each of your stressful treatment days wearing a spa robe and being crooned affirmations? Even if a fertility clinic doesn’t hire their own acupuncturist, but just refers out, that can be a marketing ploy too. Which clinic will all the acupuncturists recommend when one of their regular patients develops infertility?

          • just me

            I’m not trying to push acu here. But you and the other commentator are condescendingly painting me as a stupid sheep and my docs as fools. Really? I’m a former scientist and not stupid. Who are you to say those studies are low quality? Especially the Danish one? It’s not that ccrm throws ppl a bone on this. People with low uterine blood flow (not my issue) are routinely prescribed acu by them. I’m done with having kids and I have no stake in promoting acu and don’t have hours to argue. But really, you’re being unnecessarily condescending and rude.

            Have you gone through infertility? I’m guessing not, bc like some other posters, you assume that all of us patients are desperate impressionable fools who believe anything. Sure there are a few bad docs like in any field and some naive patients as with any issue. But to broadly paint all IF docs as scammers out to make a buck and all patients as idiots is really off base.

            And cCRM is a very successful clinic. By success I mean lots of babies. It’s hard to get in there (schedule wise not that they cherry pick). They go NOT go with the flow just to appease a patient.

          • fiftyfifty1

            It is not condescending to critique study design, it is a vital part of how science works. The studies you linked to all have major flaws:
            The Swedish study is 19 years old, had only 10(!) research subjects, had no control group at all, and has not been reproduced.
            The German study is 14 years old, was unblinded, and also has not been reproduced.
            The Danish study is 9 years old, also unreproduced, unblinded and although it reached statistical significance for women receiving acupuncture on the day of implantation, inexplicably rate was not significantly higher than control for women receiving acu on day of implantation + 2 days later. If we believe that acu on day of transfer ups rate, are we to conclude that acu 2 days after transfer causes abortion?

            On a personal level, you are right. Although I struggled with subfertility, I did not need IVF, so I don’t know what it’s like. But doctors often speak more frankly to other doctors than they do to their regular patients. I was my best friend from medical school’s support person when she went through multiple rounds of IVF as a 41 yo. When she asked her RE about acupuncture it was he who told her not to bother and that while it wouldn’t hurt the science did not show it helped and that its only benefit was to calm the women. His clinic also is well regarded, bursting at the seams and boasts excellent success rates.

          • Daleth

            The best IVF clinic in the country, the Colorado Center for Reproductive Medicine, offers acupuncture on site just prior to embryo transfer and ordered me to do six weeks of a specific acupuncture protocol at home (i.e., CCRM didn’t see a dime of that) in order to improve my uterine blood flow… which did in fact improve.

            If you tell me a reproductive endocrinologist from CCRM, ORM, SDFC, AFCC, IVF-NJ or RMA-NJ said to do or not do something, I’ll pay attention, because those are the clinics with the best success rates in the world (CCRM above all). But if you tell me some random IVF doctor your friend went to said to do or not do something… meh.

      • Laura

        As a student nurse, I do “laughter therapy” for free. If I can make my patients laugh, or even smile, then I have practiced my unique brand of medicine. I do believe it is in my “scope of practice” and acceptable under the licensing guidelines under which I must adhere to. 🙂 And I’ve never gotten in trouble for it – yet!

      • Daleth

        I’ve actually seen a number of studies in which acupuncture produced measurable effects (not merely subjective pain indicators) in rats, which negates any placebo argument. Here are a few:

        – In the World Journal of Gastroenterology, “Acupuncture at heterotopic acupoints enhances jejunal motility in constipated and diarrheic rats”
        http://www.ncbi.nlm.nih.gov/pubmed/25561794

        – In Neuroscience Letters, “Acupuncture improves locomotor function by enhancing GABA receptor expression in transient focal cerebral ischemia rats”
        http://www.ncbi.nlm.nih.gov/pubmed/25556683

        – In Neuromodulation, “Improving Testicular Blood Flow With Electroacupuncture-Like Percutaneous Nerve Stimulation in an Experimental Rat Model of Testicular Torsion”
        http://www.ncbi.nlm.nih.gov/pubmed/25284428

        A PubMed search on “acupuncture rats” will bring up tons of such studies.

        • Young CC Prof

          But how many negative studies were done to get those positive results? Were they confirmed?

          • Daleth

            “How many negative studies…” You’re assuming there were any–why? And whether there were ten or three or zero, obviously it’s not a question anyone here could answer so I’m not sure what the point of asking it is.

            “Were they confirmed?” See PubMed link above. PubMed displays related studies (related by topic, not by who did them) down the side–for instance, the one below was next to the testicular torsion study–so seek and ye shall find.

            In Reproductive Biology and Endocrinology, “Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries”
            http://www.ncbi.nlm.nih.gov/pubmed/15046638

          • Young CC Prof

            But negative studies are the most important question, for conventional medicine as well as alternative.

            Assume that a drug does nothing. Further, assume there is a group of people who really want to publish papers proving that it works, say, because they want to sell it. What stops them from just running studies over and over again until they see statistically significant results by pure chance? What stops them from examining 50 different biomarkers to look for statistically significant positive changes? The FDA is now requiring trial registration, although it’s not enforced as well as it should be.

          • Daleth

            Why would university researchers run studies over and over again until they see statistically significant results showing that acupuncture has XYZ measurable effect? What are university researchers selling?

            I can understand your hypothetical when it comes to drug companies, but am not seeing it here. The people doing peer-reviewed studies on acupuncture are generally not the people who have hung out their shingles as alternative health practitioners offering acupuncture.

            And the point, or points, remain: (1) you are assuming there must have been negative studies, since that is the only possibility that fits your world view, in which acupuncture cannot possibly work (I have to say that’s not a very scientific attitude); and (2) you’re asking a question that no one here can answer.

          • Young CC Prof

            Why does Melissa Cheyney lend her name to home birth “safety” papers with holes I could drive a truck though? Personal commitment to home birth. Many of the folks doing acupuncture studies are acupuncture believers.

            I’m asking because I’ve read the literature on acupuncture, and I see an interesting pattern: One study finds an effect on one measure. A follow-up study doesn’t confirm it, but does find an effect on a more subjective measure, or in one subgroup, or something. Always, always the studies conflict, there’s no clear pattern of agreement, and the better designed studies show smaller effects.

            I wish acupuncture worked. I’ve used it myself. It just doesn’t.

          • Young CC Prof

            Let me add that the repeated study thing doesn’t require dishonesty on anyone’s part. Let’s say ten groups of unconnected researchers are testing similar or related hypotheses. In all cases, the null hypothesis is true, that is, no effect.

            Nine of them correctly find nothing, say, “I can’t get a publication out of this!” and move on to something else. The tenth one, the one who got the wrong answer through sheer chance, is the one who actually publishes.

            And yes, this is a problem with all science.

          • Daleth

            Fair enough. So it remains a good question, for every study anyone ever does on any subject. But can we at least agree that the *uncorroborated possibility* that acupuncture studies were done with negative results and thus never published does not support a conclusion that acupuncture doesn’t work or that it hasn’t been shown, in published peer-reviewed studies, to work?

          • Young CC Prof

            No. But, I have a high standard of evidence, especially when the prior plausibility is not so good:

            1) A study so overwhelmingly positive that coincidence is absurd. A p-value along the lines of 10^-6 without significant bias in the study design, or externally confirmed cases of dying patients being saved, like penicillin did when it first came out.

            2) A large study, announced in advance, that tests one hypothesis and comes up positive without the need for subgroup analysis. (Example, MANA’s little statistics project proving that home birth raises the risk of intrapartum and neonatal death.)

            3) Multiple reasonably good studies that say basically the same thing, for example, that statins can lower your risk of heart attack if you are high risk and have high cholesterol.

            I don’t see any of those for acupuncture. I see a small study that it helps with X, and then a large study that finds the opposite.

        • The Bofa on the Sofa

          Um, anything that says “electroacupuncture” you can immediately dismiss, because it has NOTHING to do with actual acupuncture, which means sticking needles into “meridians”

          Actually, the whole concept of “electroacupuncture” is a pretty good sign of desperation by the acupuncture crowd, because they have to redefine it in order to find any effect.

          It’s like looking at a homeopathy paper where they take their homeopathic remedy and lace it with some active ingredient and show there is an effect.

          Running electrical pulses through parts of the body is not acupuncture.

          • Daleth

            Electroacupuncture means sticking needles into the same acupuncture points to stimulate the same meridians for the same reasons as plain old acupuncture. If you think the points and meridians are nonsense with no effect beyond that of a placebo, I fail to see how adding electricity changes that (i.e. how it is equivalent to adding an “active ingredient” to homeopathic formulations).

            And I have to say, it sounds like you have passed judgment on something you don’t know much about (correct me if I’m wrong)? I, in contrast, am talking about something I know at least a little about. I’ve gotten electroacupuncture from two practitioners: one an OB-GYN employed by a university hospital (she had done post-MD training in acupuncture), and one a Chinese medicine practitioner (i.e., graduate degree in Chinese herbology and acupuncture), also employed by a university hospital.

            I’ve also gotten traditional Chinese acupuncture and traditional Japanese acupuncture (same meridians and points, different needling techniques) from Chinese medicine practitioners. And I have also read some books on acupuncture for practitioners, so I’m familiar with the underlying theories (and I always liked to ask my practitioners what points they were needling and why, just out of curiosity). Oh, and I was interested enough to peruse the course catalogs at some of the acupuncture schools in North America, and indeed, electroacupuncture is taught there.

            So at least let me dispel this fog of ignorance from around you: electroacupuncture is acupuncture.

          • The Bofa on the Sofa

            Electroacupuncture means sticking needles into the same acupuncture points to stimulate the same meridians for the same reasons as plain old acupuncture.

            And then passing electricity through it.

            That’s not acupuncture. That’s using electricity.

            Moreover, the studies that have been carried out have shown that the supposed “meridians” don’t actually exist. That you get the same types of effects whether you do the activity at where you think are meridians or whether you don’t.

            Strike 2.

            And “I got electroacupuncture” doesn’t make you any more knowledgeable about the science or lack thereof that is supposed to be behind it, so you can drop that part.

            Ask all those supposed experts you’ve been to how they determined the locations of the meridians, and why it doesn’t matter whether you stick needles into meridians or not? Ask them why it doesn’t matter if you even stick needles in, if you just twirl toothpicks in the same spots? Because THAT has been shown to give the same effect as acupuncture.

            That’s what the science says about it.

          • Daleth

            You still haven’t explained how adding electricity to nonsense makes the nonsense seem to work in peer-reviewed studies. Is “electricity” synonymous with “magic” in your lexicon?

            I am also bewildered as to what qualifies you to define a particular type of acupuncture taught in acupuncture schools and practiced by acupuncturists as “not acupuncture.”

          • Poogles

            “You still haven’t explained how adding electricity to nonsense makes the nonsense seem to work in peer-reviewed studies. Is “electricity” synonymous with “magic” in your lexicon?”

            Not magic, just a basic understanding of the nervous system.

            http://www.sciencebasedmedicine.org/a-very-special-issue-of-medical-acupuncture/#more-25745

            From the above link:
            “This is, in my mind, a classic “bait and switch,” in which therapy is described as acupuncture but is in reality nothing more than electrical nerve stimulation clumsily grafted onto acupuncture. One might reasonably expect that electrical stimulation of certain nerves might have physiological effects. For instance, anyone who’s ever undergone a nerve conduction study, as I have, know this. (It’s a study that could easily be used as torture, let me tell you.) The very basis of nerve conduction is electrochemical, and it can be influenced by electrical currents. That doesn’t make it acupuncture.”

          • Daleth

            You and the author of that article both seem to think that if–as the article claims–twirling toothpicks against acupuncture points produces the same effects as inserting acupuncture needles in those points, it somehow *disproves* the theory that acupuncture is real. I don’t see the logic in that; if stimulating point X produces effect Y whether you stimulate it with a needle or a toothpick, how is that not evidence that acupuncture point X is real?

            The logic you and that author share seems especially misguided given that traditional Chinese medicine advises needling certain points in some cases, and heating them (via moxibustion, which does not even touch the skin) in others. In other words it is already the theory of Chinese medicine that stimulating those points–NOT just needling them–will produce physical effects.

            As for this–“One might reasonably expect that electrical stimulation of certain nerves might have physiological effects”– that’s true as far as it goes, but when electrical stimulation of certain acupuncture points (and thus the nerves located there) produces **the specific effects anticipated by Chinese medicine**, doesn’t your critique fall apart?

          • The Bofa on the Sofa

            Because electricity affects things without the nonsense of acupuncture.

  • Munkie

    I found it a little humorous that in both birth clips from the Born in the Wild preview the women were on their backs. I thought birth on our backs was not natural?

    • Sue

      Unless you’re in water, I guess.

  • toni

    OT: what do you science types make of this? http://www.webmd.com/children/news/20140819/children-cell-phones
    A relative of ours expressed concern today that our toddler plays with our mobile phones a lot and he was worried about the radiation, cancer link etc. (my LO likes to pretend he’s on the phone so he holds it right up to his head) I kind of brushed it off because I had looked it up a few years back and didn’t find any legitimate-looking sites claiming any health risks. but i looked it up today and found this and am freaking out a little. would setting the phone to ‘aeroplane mode’ deal with any possible radiation issue?

    • Trixie

      This is incredibly low on the list of things I’d worry about.

    • Who?

      I’d be more worried said toddler would lose interest in it and you’d spend half an hour sorting through cushions, toybox etc finding it.

    • Young CC Prof

      Remember, the type of radiation that causes cancer is ionizing. Ultraviolet light and x-rays are ionizing, that’s why too much sun can cause skin cancer.

      Cell phone radiation is non-ionizing, which means it doesn’t cause DNA damage.

      • toni

        TY everyone. so is there any truth to it being dangerous to live too close to a ‘cell tower’.

        • Young CC Prof

          Other than it possibly falling on you, no.

          • Nick Sanders

            And I wouldn’t want to be within a few feet of it during a thunderstorm. I’m pretty sure that counts as “too close”, right?

          • KarenJJ

            Step potential. The big reason not to stand too close to towers and trees during lightning storms, even without the direct hit from the lightning itself.

            http://www.angelfire.com/trek/nz_usa/lightning3.jpg

          • KarenJJ

            I should add, that towers are designed with step potential in mind.

          • deafgimp

            That’s how my relative died when he was 5. Walked too close to a telephone pole in the rain. These were Russian WWII era rural poles, which were short, like 6 or 10 feet tall.

        • Mariana Baca

          NO. The only way non-ionizing radiation can hurt you is through burning. If your cellphone gets too hot to the touch, yeah, don’t hold it against your balls or retinas or something. But otherwise, no.

    • Sue

      I always find it ironic that people express their paranoia about mobile phones while typing on their computer on the internet.

  • Sue

    In repeated “debates” with the anti-scientists, I’ve lost count of the number of times I’ve heard “western medicine is only good at emergencies and trauma”. Quite apart from the misapplication of ”western” (everyone wants effective medicine, regardless of geography), these people don’t seem to realise that all of medicine is founded on the same clinical sciences.

    I also shudder at the term ”allopathic”. Medicine is multi-modal, using the generic diagnostic process, then applying different types of therapies, depending on the condition – from antibiotics to surgery, also reassurance, counselling, vaccination, counselling, advice about diet and exercise, electrical therapy, insulin, etc etc etc.

    An effective system of medicine has modalities that address health care needs throughout the range of causes and severity, whether the cause is infective, inflammatory, traumatic, degenerative, and whether the patient is a newborn or a great grandparent.

    • Young CC Prof

      Hey, once you’ve rejected vaccines, maintenance medicines for chronic disease, blood pressure and cholesterol medicines, cancer screenings, etc, emergencies and injuries are about all that’s left.

      • Sue

        ANd the acute care system is there, ready to rescue you, no matter how much you dissed it in the past. You don’t even have to believe.

        • Kesiana

          Although it does help… I like how taking an aspirin sometimes works immediately, even though that’s not technically possible. XD

          (On the other hand, the time I ODed on Adderall in a dream and couldn’t sleep for a while afterwards sucked…)

  • Who?

    There’s always the carve out. I unintentionally desperately insulted a middle east veteran who was posting on one of these blogs, because I suggested that the only sort of soldier who wouldn’t approve of modern medicine would be the kind who never saw any front-line service. Apparently that was a terrible slur in itself, and then he conceded that, anyway, modern medicine is fine for trauma.

    He was a lovely man, said of course Steve Jobs died, as he did the wrong whole food diet (should have laid off the fruit which makes cancer grow because of the sugar) and everyone knew-who was in the know-that he would, but no one said anything. Like I said, lovely.

    I always wonder if the alternative crowd have pain relief at the dentist? And if so how do they justify it to themselves? Because surely it is poison and will mess up their chakras?

    • Young CC Prof

      When alternative medicine fails, there’s always an excuse. It wasn’t started soon enough, or the diet wasn’t correct, or the patient thought bad thoughts, or used “poisonous” medicines along with the alternative treatment.

    • nomofear

      There are people who swear by self-induced hypnotic anesthesia for dental work and beyond. I read about that when looking up Hypnobabies for childbirth while I was deep in the woo.

      • MaineJen

        Having had cavities filled without anesthesia (bad childhood dentist) and been through the better part of 2 labors without anesthesia (up until ~9cm), I don’t think even the deepest hypnosis could get rid of either pain.

        • Who?

          I’ve had similar experiences, and I agree.

          Friends tell me they meditate through some dental procedures, and say it is fabulous, but I notice the dentist puts his or her foot down when something more than a fairly shallow filling is involved. I always have the needle, because that is one off discomfort and the sounds at the dentist freak me out and that’s enough to put up with. Anyway, the quicker the dentist can work the sooner I am elsewhere, which is where I want to be.

          And labour, forget it-too wild, too unpredictable, and what if someone needs to ask you something?

      • Dr Kitty

        My mother doesn’t get local at the dentist because she has adverse reactions to the adrenaline (palpitations, anxiety, shortness of breath, headaches) so opts for gong without. She’s had root canals without local, by choice.
        But she doesn’t pretend it doesn’t hurt, just that she thinks 25 minutes of pain is better than an hour of feeling like you are dying.

        I need diazepam, headphones and music to get through a simple dental check up (thanks traumatic childhood dentist!) so that is not going to become a family tradition.

  • Well, you can pray the gay away, so why not skull fractures?

    Wait…

  • Laura

    Quacktensive Care Units (QCUs: Hilarious!

  • Tsu Dho Nimh
    • Sue

      Interestingly, they weren’t allowed near the actual sick people!

      • Nick Sanders

        Thank heaven for small favors.

    • KeeperOfTheBooks

      Oh, good gosh. My head hurts now.
      During the height of the Ebola scare in the US–if you can call it that–I took DD for a checkup at her ped’s, whose office is next door to Major Urban Hospital. Standing outside MUH were a passel of nutters waving signs and yammering about how Ebola a) was a plot by Obama to kill off the American public and b) could be prevented by taking massive quantities of Vitamin C. Which, don’t you know, is a Secret that is being Kept From The American Public by the Evil Powers That Be (TM).
      Now, I am (to put it mildly) no fan of our current president, but I find it unlikely that killing off the majority of Americans would be on his to-do list. I also think, though I consider him to be fairly incompetent, that he could manage to do more than kill a single immigrant who was ill to begin with and sicken a couple of healthcare workers if he utilized his resources to infect the American population with Ebola.
      As for Vitamin C–I guess if you take massive enough doses of it, it might give you sufficient diarrhea that you’ll be stapled to a toilet and therefore less likely to contract any illnesses from others, but that’s about it.

      • Nick Sanders

        Pretty clever of him to put his plan into action when he was only 15. Starting it in Sudan was a bit of a rookie mistake, though.

        • KeeperOfTheBooks

          Well, but he’s really African, not American! So he just started at home! Kenya, the Sudan, what’s the difference? (I seriously hope I needn’t put a sarcasm tag here, but…. /sarcasm)

  • Nick Sanders

    You were beaten to the punch:

    https://www.youtube.com/watch?v=HMGIbOGu8q0

    • Amy Tuteur, MD

      I didn’t realize that. They’re great!

      • Nick Sanders

        They really are.

      • Sue

        This is a classic – pops up frequently when ”debating” the anti-scientists.

    • Roadstergal

      I can’t see vid links at work, but I’m assuming that’s Mitchell and Webb? I adore that sketch. Especially the homeopathic lager.

      • Nick Sanders

        You assume correctly.

    • StThomas

      I used to post this all over Dana Ullman’s stuff at Huffpo. Happy days.

    • Who?

      Did you see the (satirical, of course) clip by the guy who had the bright idea to ‘cure’ the whole of a city (or maybe it was the world) by pouring a box of homeopathic first aid stuff into the water supply? He showed what was in the box, and the number of people it was supposed to ‘cure’, then took it along.

      Nothing happened.

    • Spamamander

      You beat me to the post! Cracks me up every time.

      • Laura

        The clock was so telling -or not! – and hilarious!

    • Amy

      Darn it, I was out all day. As soon as I saw Dr. Amy’s post title, I hit YouTube for the link to this. You beat me!

  • Amy M

    http://geneticliteracyproject.org/2014/10/28/organic-activists-reject-science-propose-natural-ebola-cure-claim-government-conspiracy/

    http://drsircus.com/medicine/ebola-saving-lives-natural-allopathic-medicine

    Well, there’s those guys, but they didn’t actually GO to Africa, they just sat at home and preached their nonsense conspiracy theories and made-up medicine.